Unconventional Advice I Wished Someone Told Me as a Founder in Healthcare

Between June 2023 and June 2024, I was a founder building a startup in the healthcare space. I iterated on a number of products, particularly in the Medicaid space.

It has been almost a year since I took a breather from being a full-time founder, so I wanted to take some time to reflect.

Here are some things (in no particular order) that I wish someone had told me as advice during the ideation-to-pre-seed stage.

1. It is a marathon, not a sprint.

2. If your company is successful, you may be working on the product for 8-10 years. Is that how you want to spend those years of your life?

3. One of the most important signals in raising money? Costumer traction.

4. Investors will invest in the CEO. Give as many proof points as possible that you are the right person to lead the company.

5. Work in public. This means sharing honest thoughts on what you are seeing. This can be posting on LinkedIn and humble bragging—less about yourself and more about the progress of your product.

6. If you are bootstrapping a company, plan to take some consulting work on the side if possible.

7. Talking to ChatGPT is great, though more than likely, it will be a “yes person.” Be careful when ideating—you may be wearing rose-colored glasses.

8. A partnership ≠ product traction.

9. Distribution, not the product, is a critical bottleneck—meaning how you get sales connections and how you get your product in the hands of users.

10. A lot of the core challenges in healthcare are individual organizational challenges and the misaligned incentives of healthcare. Not technology.

11. Channel partnerships are your friend. But make sure they will directly result in revenue on the other side if things go well.

12. If you are doing a D2C2B play, make sure you have a few realistic paths to a viable business model.

13. Don’t focus on bringing in big-name advisors. Bring in friends you trust and get along with.

14. If you are bringing on a product lead as one of your first few hires, that’s a bad signal. You, as the founder, should be the product leader for a decent period during the early stage of your company.

15. Develop a pitch deck that is as transparent as possible. Stupid investing deals happen all the time, but frankly, you want smart investors working with you.

16. You most likely don’t need investors to build and launch your product. Getting investors is more about scaling what is already working.

17. Figma and Miro are your best friends. Use them to map out customer pain points, visualize how your product solves them, and see exactly where it fits into their workflow. This process will reveal gaps, opportunities, and even whether your product is the right fit—or if it won’t work at all.

18. The whole thing about trying to talk to 100 people in the space is great, but realistically, you are better off talking to a few people who really understand the space.

19. Yes, your product may result in an ROI, but if it is not one of the most important pain points your customer profile faces, no one will buy it.

20. In the pre-seed stage, you may be in a tough position where you need capital to get a team, but you need a team to get capital. It sucks. I don’t have a great answer. Ideally, lean on product progress and a few friends willing to work in a very limited capacity.

21. Learn to iterate quickly based on market signals and be prepared to change course if necessary.

22. Don’t take advice from your friends, family, and people who will not be brutally honest and who understand the domain space. It is not a malicious thing, but they are most likely just being nice.

23. Identify key performance indicators—like customer acquisition cost, lifetime value, and churn—and track them closely.

24. Build genuine relationships within your industry for strategic partnerships, referrals, and potential funding. The Health Tech Nerds’ Slack community is a game-changer.

25. Craft a compelling narrative that resonates with both investors and customers, clearly articulating your vision and mission.

26. Beware of vanity metrics that feel good but don't correlate with actual business success. Focus on metrics that truly indicate growth.

27. Better sleep is more productive than overworking.

28. And more generally, taking time off can be more productive than working.

Anyway, this is where my mind is at on an early spring afternoon in North Carolina.

Shoot me an email if you have any advice to add.